下肢慢性静脉功能不全患者局部sICAM-1、sVCAM-1含量变化探究.docVIP

下肢慢性静脉功能不全患者局部sICAM-1、sVCAM-1含量变化探究 　【摘要】 目的:研究下肢慢性静脉功能不全（CVI）患者在不同体位下局部血清中sICAM-1、sVCAM-1的含量变化。方法:选取单侧肢体病变的CVI患者20例，双下肢均经过双功彩超和静脉造影明确诊断，在经过30 min下肢静止站立后分别抽取双下肢静脉血，同时取上肢静脉血作为对照组，尔后取平卧位15 min后再取双下肢静脉血。分为曲张静脉＋静脉高压组(Vh组)、正常静脉＋静脉高压组(Nh组)、曲张静脉压力解除组（Vr组）、正常静脉压力解除组(Nr组)和上肢对照组5组。用酶联免疫吸附法（ELISA）检测血浆中的sICAM-1、sVCAM-1的含量。结果:①Vh组和Nh组的sICAM-1、sVCAM-1明显高于对照组（Plt;0.01），而Vh组和Nh组之间差异无显著性（Pgt;0.05）。②Nr组和Nh组相比，sICAM-1、sVCAM-1均下降（Plt;0.05）。③Vr组和Vh组相比，sICAM-1、sVCAM-1无明显变化（Pgt;0.05）。结论:下肢静脉系统在血流淤滞和静脉高压的情况下，无论是否本身静脉有异常，局部的内皮细胞和白细胞均有激活并表达黏附分子。而在静脉压力解除后，曲张静脉中局部的黏附分子高水平提示炎症仍持续，而正常静脉则可短时间内下降。曲张静脉炎症反应的持续性可能是CVI发展的重要过程。 【关键词】 静脉功能不全 黏附分子 ICAM-1 VCAM-1 Abstract: Objective: To explore the changes of sICAM-1，sVCAM-1 in local plasma with blood stasis and after relieved of blood stasis in varicose veins and normal veins. Methods: Twenty patients with CVI were selected. Venous insufficiency only in one side was verified by Duplex ultrasonic scanning and venography. After a stasis for 30 minutes, blood was sampled both in the varicose vein (group Vh) and in the normal vein of both lower limbs in standing position (group Nh). At the same time, blood in the brachial vein was sampled as a group of control. After relief in both lower of stasis (supine position) for 15 minutes, blood was sampled in the varicose vein(group Vr) and normal vein(group Nr). sICAM-1 and sVCAM-1 were measured in plasma with ELISA kits. Results: ①After blood stasis, Plasma sICAM-1 and sVCAM-1 were higher in group Vh and group Nh than that of the contral group (Plt;0.01). After blood stasis, there was no significant difference between group Vh and group Nh （Pgt;0.05）. ②After a relief of stasis for 15 minutes,the sICAM-1 and sVCAM-1 decreased in the normal vein of lower limb(Plt;0.05). ③In the varicose vein, there was no variation in the sICAM-1 and sVCAM-1 after relief of stasis for 15 minutes. Conclusion: In the conditions of blood stasis and hypoxia, no matter in varicose veins or normal veins, local leukocytes adhension and va